The Influence of Language Context on Repetitive Speech Use in Children With Autism Spectrum Disorder

Purpose Although repetitive speech is a hallmark characteristic of autism spectrum disorder (ASD), the contributing factors that influence repetitive speech use remain unknown. The purpose of this exploratory study was to determine if the language context impacts the amount and type of repetitive speech produced by children with ASD. Method As part of a broader word-learning study, 11 school-age children with ASD participated in two different language contexts: storytelling and play. Previously collected language samples were transcribed and coded for four types of repetitive speech: immediate echolalia, delayed echolalia, verbal stereotypy, and vocal stereotypy. The rates and proportions of repetitive speech were compared across the two language contexts using Wilcoxon signed-ranks tests. Individual characteristics were further explored using Spearman correlations. Results The children produced lower rates of repetitive speech during the storytelling context than the play-based context. Only immediate echolalia differed between the two contexts based on rate and approached significance based on proportion, with more immediate echolalia produced in the play-based context than in the storytelling context. There were no significant correlations between repetitive speech and measures of social responsiveness, expressive or receptive vocabulary, or nonverbal intelligence. Conclusions The children with ASD produced less immediate echolalia in the storytelling context than in the play-based context. Immediate echolalia use was not related to social skills, vocabulary, or nonverbal IQ scores. These findings offer valuable insights into better understanding repetitive speech use in children with ASD.

A Multidimensional Reappraisal of Language in Autism: Insights from a Discourse Analytic Study

In this article, we leverage theoretical insights and methodological guidelines of discourse analytic scholarship to re-examine language phenomena typically associated with autism. Through empirical analysis of the verbal behavior of three children with autism, we engage the question of how prototypical features of autistic language-notably pronoun atypicality, pragmatic deficit, and echolalia-might conceal competencies and interactional processes that are largely invisible in mainstream research. Our findings offer a complex picture of children with autism in their use of language to communicate, interact and experience others. Such a picture also deepens our understanding of the interactional underpinnings of autistic children's speech. Finally, we describe how our findings offer fruitful suggestions for clinical intervention.

On the differential nature of induced and incidental echolalia in autism

BACKGROUND

Echolalia is a verbal disorder, defined as 'a meaningless repetition of the words of others'. It is pathological, automatic and non-intentional behaviour, often observed in a variety of neurological and psychiatric disorders and above all in autism. We assume that echolalia is an imitative behaviour that is due to difficulties in inhibiting automatic repetition as seen in patients with frontal lobe damage. Our aim is to study the occurrence of echolalia under experimental conditions to investigate the nature of the phenomenon and its relationship with the severity of autism.

METHODS

Eighteen participants with autism from 17 to 36 years old were recruited; they were administrated the Vineland scale, the Observational Rating Scale of Basic Functions and the Echolalia Questionnaire. In the Echolalia Questionnaire, questions were directly addressed to the autistic subject (induced procedure) or to the subject's caregiver while the subject was free to do what he wanted (incidental procedure). The data were analysed by multivariate regressions and Pearson's correlations.

RESULTS

The results showed that echolalia occurred in both experimental situations; the mean value was significantly higher in the induced procedure, but results did not support the correlation with Vineland's score in the incidental procedure. It is likely that the two situations activated different processes. In particular, echolalia was statistically higher in the induced procedure as compared with the incidental one only for subjects with low score on Vineland, but in the incidental procedure, the presence of echolalia appeared to be uninfluenced by the functional capacity of subjects.

CONCLUSIONS

The two experimental conditions require different monitoring systems to control this verbal behaviour. The echolalic phenomenon is an expression of dependence on the environment and may occur in a situation in which the autistic person is participating in a communicative act and, lacking inhibitory control, repeats the other's communication rather than selecting an answer. The deficit in inhibitory control in this situation does not seem to be present in subjects with higher efficiency. Incidental echolalia reflects the inability of the subject to filter out background environmental noise, which occasionally results in environmental dependency.

Do Japanese children with high-functioning autism spectrum disorder respond differently to Wh-questions and Yes/No-questions?

The present study compared 12 Japanese children with high-functioning autism spectrum disorder (HFASD), ranging in age from 7.3-14.8 years, with 12 typically developing (TD) children matched for age, gender, and vocabulary. The means of full-scale IQ and verbal-IQ of the children with HFASD were 95.92 (SD = 15.30) and 98.00 (SD = 18.44), respectively. Children responded to questions from their mothers in conversations collected under a semi-structured setting, and the responses of both groups were examined from the viewpoint of adequacy. Compared to TD children, HFASD children produced more inadequate responses to Wh-questions than to Yes/No questions. To both types of questions, HFASD children produced more inappropriate responses than TD children. The findings suggest that parents of HFASD children should consider the influence of the question format on these children's response inadequacies.

Criminal and legal responsibilities in Tourette's syndrome

Tourette's Syndrome (TS) is a neuropsychological disorder characterized by the presence of multiple involuntary motor tics accompanied by one or more vocal tics. Articles about TS and criminal responsibility and the restriction of civil rights are limited. A person with TS was evaluated to consider his criminal responsibility after swearing at a referee during a football game. He was also evaluated as to whether or not he was capable of professionally driving a service bus. Additionally, medico-legal situations regarding military service, obtaining a shotgun license and marriages of patients with TS were considered.

Two forms of spoken repetition in a girl with autism

BACKGROUND

The talk of persons with autistic spectrum disorders (ASD) often features distinctive forms of repetition (echophenomena). Although often characterized as meaningless or inappropriate, there is evidence that such practices can sometimes have communicative functions.

AIMS

To investigate the interactional organization of repetition practices found in the talk of an adolescent girl with an ASD.

METHODS & PROCEDURES

As part of a project examining the interactional practices of children with ASD, we video-recorded 6 hours of activity in a school classroom for severe learning difficulty (SLD) children. This paper considers instances of repeated talk produced by a class pupil, 'Helen'. The analysis involved assembling a collection of examples of the repeated talk which were then transcribed in detail. Conversation Analysis was used to explore the sequential contexts in which they occur and precisely how they are produced.

OUTCOMES & RESULTS

Two forms of repetition occur very frequently in Helen's talk: first, repeats of turn-final lexical items from another speaker's immediately before talk (prior-turn repeats, a form of immediate echolalia), and second, repeats of the first item within a turn such that a turn is produced consisting entirely of repeated items (within-turn repeats). The latter appears to be a form of palilalia (repeats of one's own prior talk) that has not been widely reported in ASD. The prior turn repeats follow other speaker's initiating actions (e.g. questions) that are addressed specifically to Helen and make a response from her relevant. Helen apparently uses these to demonstrate that she has nevertheless heard, and is orienting to, that prior turn. Within-turn repeats are tied to and bounded by the accomplishment of non-vocal activities, e.g. handing an object to a co-participant, such that the repetitions cease when the object has reached its recipient. The two forms of repetition frequently co-occur to display on-going engagement with a recipient's prior turn.

CONCLUSIONS

Although Helen has limited verbal resources she is more interactionally competent than this may initially suggest. We propose that these repetition practices may constitute an adaptation to interacting with a limited lexicon. We discuss the relevance of Conversational Analysis for understanding autistic children's pragmatic competence, and the implications for remediation and further research.

Using time-delay to improve social play skills with peers for children with autism

Interventions that teach social communication and play skills are crucial for the development of children with autism. The time delay procedure is effective in teaching language acquisition, social use of language, discrete behaviors, and chained activities to individuals with autism and developmental delays. In this study, three boys with autism, attending a non-public school, were taught play activities that combined a play sequence with requesting peer assistance, using a graduated time delay procedure. A multiple-baseline across subjects design demonstrated the success of this procedure to teach multiple-step social play sequences. Results indicated an additional gain of an increase in pretend play by one of the participants. Two also demonstrated a generalization of the skills learned through the time delay procedure.

A retrospective journal-based case study of an infant with autism and his twin

This report describes the development of an infant who was later diagnosed with autism, and a direct comparison of his development to that of his twin, from a prenatal period through the age of 4 years, through the examination of personal journals and medical records kept by the mother of the twins. Examination of these journals revealed several differences in development between the twins, some as early as 6 months of age. In the first year of life, the infants already differed in language development, social development, sleep patterns, and sensitivity to pain. This rare opportunity to view early autistic development gives direction to developmental theories of autism and clinically useful cues to early signs of autism.

Chronic 'speech catatonia' with constant logorrhea, verbigeration and echolalia successfully treated with lorazepam: a case report

Logorrhea, verbigeration and echolalia persisted unremittingly for 3 years, with occasional short periods of motoric excitement, in a patient with mild intellectual handicap suffering from chronic schizophrenia. The speech catatonic symptoms, previously refractory to various antipsychotics, responded promptly to lorazepam, a benzodiazepine with documented efficacy in the treatment of acute catatonia but not chronic catatonia. It is suggested that pathways in speech production were selectively involved in the genesis of the chronic speech catatonic syndrome, possibly a rare form of chronic catatonia not previously described.

Effects of a Computer-Based Intervention Program on the Communicative Functions of Children with Autism

This study investigated the use of computer-based intervention for enhancing communication functions of children with autism. The software program was developed based on daily life activities in the areas of play, food, and hygiene. The following variables were investigated: delayed echolalia, immediate echolalia, irrelevant speech, relevant speech, and communicative initiations. Multiple-baseline design across settings was used to examine the effects of the exposure of five children with autism to activities in a structured and controlled simulated environment on the communication manifested in their natural environment. Results indicated that after exposure to the simulations, all children produced fewer sentences with delayed and irrelevant speech. Most of the children engaged in fewer sentences involving immediate echolalia and increased the number of communication intentions and the amount of relevant speech they produced. Results indicated that after practicing in a controlled and structured setting that provided the children with opportunities to interact in play, food, and hygiene activities, the children were able to transfer their knowledge to the natural classroom environment. Implications and future research directions are discussed.

Phenomenology of tics and natural history of tic disorders

Tic symptoms, the hallmark of Tourette's syndrome (TS), may simply be fragments of innate behavior. As such, the sensory urges that precede tics may illuminate some of the normal internal cues that are intimately involved in the assembly of behavioral sequences. The occurrence of tics in time appears to have fractal characteristics that may help to explain the waxing and waning course of tic disorders. Longitudinal studies are currently underway that should permit a close examination of the natural fluctuations in tic severity using valid and reliable clinician-rated scales of tic severity. The natural history of tics typically shows a marked decline during the course of adolescence. However, TS can also be associated with social, emotional, and academic difficulties in early adulthood. Comorbid attention deficit/hyperactivity disorder and obsessive-compulsive disorder are likely to influence the long-term adaptive outcomes of individuals with TS. Future progress may also be expected as endophenotypes, and possibly genetic markers, are identified that are associated with specific comorbid conditions and etiologically distinct forms of TS.

Effortful echolalia

We report three cases of effortful echolalia in patients with cerebral infarction. The clinical picture of speech disturbance is associated with Type 1 Transcortical Motor Aphasia (TCMA, Goldstein, 1915). The patients always spoke nonfluently with loss of speech initiative, dysarthria, dysprosody, agrammatism, and increased effort and were unable to repeat sentences longer than those containing four or six words. In conversation, they first repeated a few words spoken to them, and then produced self initiated speech. The initial repetition as well as the subsequent self initiated speech, which were realized equally laboriously, can be regarded as mitigated echolalia (Pick, 1924). They were always aware of their own echolalia and tried to control it without effect. These cases demonstrate that neither the ability to repeat nor fluent speech are always necessary for echolalia. The possibility that a lesion in the left medial frontal lobe, including the supplementary motor area, plays an important role in effortful echolalia is discussed.

Teaching receptive naming of Chinese characters to children with autism by incorporating echolalia

The facilitative effect of incorporating echolalia on teaching receptive naming of Chinese characters to children with autism was assessed. In Experiment 1, echoing the requested character name prior to the receptive naming task facilitated matching a character to its name. In addition, task performance was consistently maintained only when echolalia preceded the receptive manual response. Positive results from generalization tests suggested that learned responses occurred across various novel conditions. In Experiment 2, we examined the relation between task difficulty and speed of acquisition. All 3 participants achieved 100% correct responding in training, but learning less discriminable characters took more trials than learning more discriminable characters. These results provide support for incorporating echolalia as an educational tool within language instruction for some children with autism.

Psychopathology of catatonic speech disorders and the dilemma of catatonia: a selective review

OBJECTIVE

Over the past decade there has been an upsurge of interest in the prevalence, nosological position, treatment response and pathophysiology of catatonia. However, the psychopathology of catatonia has received only scant attention. Once the hallmark of catatonia, speech disorders--particularly logorrhoea, verbigeration and echolalia--seem to have been neglected in modern literature. The aims of the present paper are to outline the conceptual history of catatonic speech disorders and to follow their development in contemporary clinical research.

METHOD

The English-language psychiatric literature for the last 60 years on logorrhoea, verbigeration and echolalia was searched through Medline and cross-referencing. Kahlbaum, Wernicke, Jaspers, Kraepelin, Bleuler, Kleist and Leonhard's oft cited classical texts supplemented the search.

RESULTS

In contrast to classical psychopathological sources, very few recent papers were found on catatonic speech disorders. Current clinical research failed to incorporate the observations of traditional descriptive psychopathology.

CONCLUSIONS

Modern catatonia research operates with simplified versions of psychopathological terms devised and refined by generations of classical writers.

Environment-driven responses in progressive supranuclear palsy

The neurological signs and behaviors that accompany degenerative diseases associated with fronto-striatal dysfunction are incompletely described. We observed several novel environmentally-driven behaviors in seven patients with progressive supranuclear palsy (PSP). All patients had cognitive deficits with greatest impairments on tests of frontal lobe function, and frontal lobe cerebral perfusion was significantly reduced in 4 of the 5 who had single photon emission computed tomography (SPECT) brain scans. Visual grasping, in which a patient's gaze was attracted to an incidental object in the environment such as a TV set or mirror, was preeminent. Once fixed, there was inability to release the gaze and shift to another object. In other instances, removing a table placed in front of a patient or unbuckling of his seat belt would make him stand up, which was impossible on command. Similarly, playing music would induce rhythmic foot beating, which was never obtained on command. There were compulsive utilization behaviors, such as repetitively picking up and replacing the telephone for no apparent reason. As expected, there were signs of heightened facial reflexes, grasp reflexes, apraxia of eyelid opening, echolalia and echopraxia. We postulate that these stimuli-oriented behaviors stem from parietal lobe disinhibition due to fronto-striatal dysfunction.

Effects of high and low constraint utterances on the production of immediate and delayed echolalia in young children with autism

This study examined the effects of adult antecedent utterances on the occurrence and use of echolalia in children with autism during a free play setting. Adult antecedent utterances were differentiated into two types, high and low constraint, based on the degree of linguistic constraint inherent in the adult utterance and social-communicative control exerted on the child's social and verbal interaction. Results of this study identified a variety of patterns of echolalia usage following adult high and low constraint utterances. Overall results found that a majority of immediate echoes followed high constraint utterances and were primarily used as responsives, organizational devices, and cognitives. The majority of delayed echoes followed low constraint utterances and were primarily used as requestives, assertives, and cognitives. Delayed echoes were more likely than immediate echoes to be produced with evidence of comprehension, but there were no differences in comprehension within the two categories of echolalia following high and low constraint utterances. Educational implications are discussed.

I, you, me, and autism: an experimental study

The nature of autistic individuals' abnormalities in the use of personal pronouns has been a topic of considerable speculation but little systematic investigation. We tested groups of CA- and verbal MA-matched autistic and nonautistic mentally retarded children and young adults on a series of tasks that involved the comprehension and use of the personal pronouns "I," "you," and "me." All subjects were able to comprehend these pronouns within the test situations, and there were few instances of pronoun reversal. However, autistic subjects were significantly less likely to employ the pronoun "me" in a visual perspective-taking task (when instead they tended to say: 'I can see the . . .'), and lower ability subjects were more likely to use their own proper names rather than personal pronouns in certain photograph-naming tasks. There were also circumstances in which autistic subjects were less likely than controls to employ the pronoun "you" to refer to the experimenter. A high proportion of these autistic subjects were reported to have current difficulties with personal pronouns in their everyday life, and we discuss some alternative interpretations of the results.

An evaluation of two methods for increasing self-initiated verbalizations in autistic children

Three children with autism and mental retardation were treated for deficits in self-initiated speech. A novel treatment package employing visual cue fading was compared with a graduated time-delay procedure previously shown to be effective for increasing self-initiated language. Both treatments included training multiple self-initiated verbalizations using multiple therapists and settings. Both treatments were effective, with no differences in measures of acquisition of target phrases, maintenance of behavioral gains, acquisition with additional therapists and settings, and social validity.

The effects of two levels of linguistic constraint on echolalia and generative language production in children with autism

The effects of specific types of adult antecedent utterances (high vs. low constraint) on the verbal behaviors produced by three subjects with autism were examined. Adult utterance types were differentiated in terms of the amount of control the adults exhibited in their verbal interactions with the subjects during a free play setting. Videotaped interactions were analyzed and coded according to a predetermined categorical system. The results of this investigation suggest that the level of linguistic constraint exerted on the child interactants during naturalistic play sessions affected their communicative output. The overall findings suggest that (a) adult high constraint utterances elicited more verbal utterances in general, as well as a majority of the subjects' echolalia; (b) adult low constraint utterances elicited more subject high constraint utterances; and (c) the degree of constraint of adult utterances did not appear to influence the mean lengths of subjects' utterances. The results are discussed in terms of their implications for educational interventions, and suggestions are made for future research concerning the dynamics of echolalia in interactive contexts.

Long-term follow-up of echolalia and question answering

A long-term follow-up of echolalia and correct question answering was conducted for 6 subjects from three previously published studies. The follow-up periods ranged from 26 to 57 months. In a training site follow-up, subjects were exposed to baseline/posttraining conditions in which the original trainer and/or a novel person(s) presented trained and untrained questions. Four subjects displayed echolalia below baseline levels, and another did so in some assessments. Overall, echolalia was lower than in baseline in 80.6% of the follow-ups. Five subjects displayed correct responding above baseline levels. No clear differences were noted in correct responding or echolalia between the trainer and novel-person presentations or between trained and untrained questions. In a follow-up in a natural environment conducted by a novel person, lower than baseline levels of echolalia were displayed by 3 subjects; 2 subjects displayed lower than baseline levels in some assessments. Two subjects consistently displayed correct responding above baseline, and 3 did so occasionally. Issues related to the study of maintenance are discussed.

Conversational analyses of males with fragile X, Down syndrome, and autism: comparison of the emergence of deviant language

Deviant, repetitive language of 33 males (9 with Down syndrome, 12 with fragile X (fra[X]) syndrome, and 12 with autism) was analyzed within three conversational contexts: direct responses, initiation of new material, and topic maintenance. Results indicated that males with fra(X) manifest deviant, repetitive language that is distinct from males with either Down syndrome or autism. Thus, the deviant repetitive language of males with fra(X) cannot be accounted for by either their level of adaptive functioning or autistic-like behaviors per se. Possible explanations for this etiologically specific language deviance were discussed.

The psychopathology of echophenomena

Repetition of other person's activities is, to some extent, part of normal human behaviour. However, in some circumstances it becomes pathological and symptomatic of an underlying disease process. The pathogenesis of this type of behaviour is very diverse. The circumstances in which echoing can be expected to occur are reviewed.

Echolalia and comprehension in autistic children

The research reported in this paper investigates the phenomenon of echolalia in the speech of autistic children by examining the relationship between the frequency of echolalia and receptive language ability. The receptive language skills of 10 autistic children were assessed, and spontaneous speech samples were recorded. Analysis of these data showed that those children with poor receptive language skills produced significantly more echolalic utterances than those children whose receptive skills were more age-appropriate. Children who produced fewer echolalic utterances, and had more advanced receptive language ability, evidenced a higher proportion of mitigated echolalia. The most common type of mitigation was echo plus affirmation or denial.

The functions of immediate echolalia in autistic children: a developmental perspective

This study examined differences in the use of immediate echolalia by autistic children at different stages of language development. Eighteen autistic children, aged 4 to 12 years, were videotaped in play sessions with a parent and with an examiner. Data were collected on frequency of echolalia, percentage of language that was echolalic, functions of echolalia (Prizant & Duchan, 1981), chronological age, nonverbal mental age, and language level. Frequency of immediate echolalia varied with expressive language level but not with nonverbal mental age or chronological age. The percentage of language that was echolalic was high at early stages of language development but decreased as language skills improved. No significant relationships were found between number of functions and language level, chronological age, or nonverbal mental age. Although coding of functions was reliable, the validity of functional categories for echolalia was not strongly supported. Implications for autistic language development and for methodology in this area are discussed.

Setting effects on the occurrence of autistic children's immediate echolalia

This study was designed to assess the effects of setting familiarity on autistic children's immediate echolalia. Six autistic boys were presented with a receptive labeling task in several settings varying in familiarity of person, room, and task stimuli. The amount of immediate echolalia emitted during the task in each of the settings was recorded. The results indicated that the greatest amount of echolalia occurred in settings in which an unfamiliar person presented unfamiliar task stimuli. The second greatest amount of echolalia occurred when a familiar person presented the unfamiliar stimuli. The results are discussed in terms of previous literature, classroom design, and treatment procedures for autistic children.

[A psycholinguistic study in a patient with echolalia]

Language is often impaired in patients with a primary degenerative dementia syndrome. Severe dementia may even lead to mutism, a condition in which the person does not produce any spontaneous speech, despite preservation of consciousness. The question is if there are any language abilities left in patients who do not speak. In this single case-study the echolalic behaviour of a patient with severe dementia and mixed transcortical aphasia (or isolation of the speech area) was analysed by means of special linguistic tasks. In repeating sentences violating number agreement, the patient spontaneously corrected the pronoun, the noun or the verb. Furthermore, her verbal output during repetition tasks was highly constrained to lexically acceptable Dutch nouns. Despite extremely poor comprehension, this patient did not repeat verbal utterances in a parrot-like fashion. There are not many reports in the literature of patients who develop a mixed transcortical aphasia as a consequence of primary degenerative dementia. A comparable case was described by H. Whitaker. Single case-studies, such as these, are essential to our insight into the course of language breakdown in senile dementia. The preserved repetition ability of this patient demonstrates the robustness of the articulatory loop system, even if there is a severe comprehension deficit.

Learning and self-stimulation in mute and echolalic autistic children

The effects of self-stimulation on task acquisition were studied in three mute low-functioning autistic and three echolalic higher-functioning autistic children in multiple-baseline designs. The study found that (a) the echolalic children were able to learn the task without external suppression of their self-stimulation and (b) the mute children were unable to learn the task until their self-stimulation was externally suppressed. It was suggested that the echolalic children may have acquired the ability to discriminate when to self-stimulate, so that their self-stimulation does not interfere with correct responding.

Language acquisition and communicative behavior in autism: toward an understanding of the "whole" of it

Deviant language characteristics, deficits in social interaction, and ritualistic and compulsive behaviors are now considered to be among the definitive characteristics of the autistic syndrome. There have been few attempts to bring a sense of cohesion to the varied communicative symptomatology evident in autism, because much of the research literature has been product oriented rather than process oriented, and has focused on language structure rather than function. Therefore, behaviors such as immediate echolalia, delayed echolalia, and interactive rituals are often viewed as isolated, deviant phenomena, rather than as phenomena related to predominant cognitive processing modes and cognitive-linguistic development in autism. This discussion reviews symptomatology of autistic communication in reference to "gestalt" versus "analytic" modes of cognitive processing, language acquisition, and language use. Based on research on language behavior of normal and autistic children, specific issues are considered, including a reconsideration of echolalic behaviors, patterns of social interaction, and patterns of cognitive-linguistic development in autism.

The effects of echolalia on acquisition and generalization of receptive labeling in autistic children

This investigation, consisting of two experiments, was designed to assess the effects of autistic immediate echolalia on acquisition and generalization of receptive labeling tasks. Experiment 1 addressed whether autistic children could use their echolalia to facilitate acquisition. The results indicated that incorporating echolalia (echo of the requested object's label) into the task before manual response (handing the requested object to the experimenter) facilitated receptive labeling. Experiment 2 was designed to determine the effects of incorporating echolalia into task response on acquisition and subsequent generalization. These results indicated that echolalia facilitated generalization for echolalic autistic children but not for functionally mute autistic children. The results of the experiments are discussed in terms of stimulus control. Additionally, it is proposed that perhaps in certain cases, echolalia should not be eliminated, but used to advantage in receptive responding.

Echolalic and spontaneous phrase speech in autistic children

The study investigated the syntactical level of spontaneous and echolalic utterances of 26 autistic children at different stages of phrase-speech development. In children using very brief utterances, echolalic phrases were significantly longer than their spontaneous speech. At higher levels of language development there were no significant differences between the lengths of echoed and spontaneous utterances. The frequency of echolalic phrases in children's speech was also found to be significantly less than the frequency of their spontaneous remarks, and the frequency of echolalic utterances declined as children advanced in linguistic competence.

Delayed echolalia in autism: some observations on differences within the term

Attention has recently focused on the need to build up a corpus of case observations relating to the function of delayed echolalia in various handicapping conditions but especially in early childhood autism. This present article offers six functional categories as an aid to clear reporting of observation and, thus clarification of this little-understood facet of deviant language development.

The functions of immediate echolalia in autistic children

This research was intended to discover how immediate echolalia functioned for autistic children in interactions with familial adults. For echolalic children were videotaped at school and at home, in both group and dyadic interactions in natural situations such as lunchtime, family activities, and play activities in school. After conducting a multilevel analysis (of over 1,000 utterances) of verbal and nonverbal factors, response latency, and intonation, it was discovered that immediate echolalia is far more than a meaningless behavior, as has been previously reported. Seven functional categories of echolalia were discovered and are discussed in reference to behavioral and linguistic features of each category. It is argue that researchers who propose intervention programs of ech-abatement may be overlooking the important communicative and cognitive functions echolalia may serve for the autistic child.

Echolalia: issues and clinical applications

Echolalic behaviors have been reported within the context of various pathologies but have remained poorly defined. Consequently, it is not easy to determine whether and to what extent normal repetition can be separated from pathological echoing. Hence, it is unclear whether the occurrence of echolalic behavior may be useful for differential diagnostic purposes. Also, much room is left for controversies about the clinical management of echolalic behavior. This article reviews the various conditions associated with echolalia and the role of repetitions in normal language behavior. Suggestions are made in terms of the various dimensions along which echolalic behavior should be assessed, as well as of the desirability of particular intervention techniques.

Personal pronouns and the autistic child

The long-recognized difficulties of the speaking autistic child with the use and nonuse of personal pronouns ["reversals" and "avoidance"] have been generally attributed either to the nondifferentiation of the self or to the frequently coexisting symptom of echolalia. These explanations are reconsidered in this eclectic analysis from the perspective of current theory and research in development of self and of language. Emphasis is on studies of normal development of personal pronouns and the roles played in that process by listening, echoic memory, mitigated echolalia [recoding], and person deixis. It is concluded that multiple developmental obstacles of a social, cognitive, and grammatical nature underlie the more obvious symptoms and militate against the child's resolution of labels and their referents. Treatment alternatives that de-emphasize the primacy of I are offered.

Pantomimic representation in psychotic children

Previous research suggests that verbal deficits among psychotic children may be paralleled by deficits in nonverbal pantomime. However, certain questions such as the level of pantomime exhibited by psychotic children, its susceptibility to modification, and its relation to other symbolic functions have not been systematically examined. To investigate these issues, 24 psychotic children were required to represent absent objects (e.g., toothbrush) via pantomime after receiving verbal instructions or instructions accompanied by a model demonstrating the pantomime. Also, measures of receptive and expressive speech, human figure drawings, and pretend play were obtained. The findings indicated very few complete failures in pantomime; higher pantomime performance when a model was provided although even in this condition most responses consisted of low-level substitutions of a body part in place of the absent object; and significant relationships between pantomime and measures of receptive vocabulary, echolalia, drawing, and play. The relationship of the findings to symbolic functioning in normal children and their relevance to understanding symbolic deficits in psychotic children are discussed.

Social and attentional aspects of echolalia in highly echolalic mentally retarded persons

Echolalia was examined in a sample of highly echolalic mentally retarded individuals. When presented with a standard set of questions, under conditions differing in appropriateness for exchange of discourse (e.g., questions presented with examiner and patient face-to-face vs. questions presented with the examiner's face averted vs. questions addressed towards another person sitting silently beside the patient), subjects' frequency of echolalia varied. Besides showing considerable sensitivity to aspects of discourse exchange, subjects exhibited some limited capacity for processing linguistic information.